[Permanent disability and death among German workers with depression]

It was the aim of this study to estimate effects of depression on permanent disability and death in a statutory health insurance population.

Data from 128,001 clients were used with a mean follow up of 6.4 years. Excess risks were calculated with Cox regression models adjusted for age, gender, education and job classification.

Outpatient treatment for depression was associated with an elevated relative risk for permanent disability, but inpatient treatment even more so. Life table analysis suggests higher risks of early retirement for males who get ill early in life. Depression treated solely in an outpatient setting may be associated with lower mortality early in life, but this was only significant for women.

Outpatient treatment should include an emphasis on occupational functioning, but also a gender-specific approach is needed.